Controversies In The Treatment Of Prostate Cancer

Treatment strategies in prostate cancer underlie a permanent change due to continuous improvements. Based on the 10th International Symposium on Special Aspects of Radiotherapy held in Berlin in 2006, this volume highlights key advances in surgical, radiooncological and systemic treatment standards for prostate cancer. Furthermore, interdisciplinary co-operations and controversies are presented and future developments are discussed. The four parts of the book cover the different stages of the disease - localized prostate cancer, the lymph node positive situation, biochemical recurrence, and hormone-refractory and metastatic prostate cancer. Special attention is given to the value and sequence of systemic treatment options in relation to surgery and radiotherapy.Proving the reader with the latest treatment standards of prostate cancer, this book will be of great value to urologists and radiation oncologists as well as to all others involved in the care of patients with prostate cancer.

These proceedings emanate from the Second Prouts Neck Conference on prostate cancer held on October 17-19, 1986, the theme of which was treat ment, with focus on current issues and future research that is needed to answer critical questions related to optimal management of the various stages of prostate cancer. The objective was to reveal the most crucial problems impeding progress and to crystallize the combined multidisci plinary input generated by the conference into focused concepts or recommendations for presentation to the National Cancer Institute (NCI) , with the ultimate intent of targeting research to address the priority issues identified. In organizing the workshop, every effort was made to maintain a multidisciplinary balance among nationally renowned authorities on prostate cancer. Thus, leading surgeons, radiation and medical onco logists and biostatisticians were in equal presence. While there were spirited exchanges with careful scrutiny and critique of all data pre sented, there was a common belief that the challenge of prostate cancer would be best approached in this multidisciplinary Organ Systems-oriented fashion. During the course of the conference, it became apparent to all present that major nomenclature and procedural barriers have made it generally difficult, and frequently impossible, to compare results of clinical research.

The use of radical prostatectomy in patients with high risk of recurrence has significantly increased during the past 10 years. Thus, adjuvant radiation as a part of multimodality treatment or salvage radiation at the evidence of prostate-specific antigen (PSA) progression represents mainstay curative-intent options for a great number of prostate cancer patients. Although, few randomized trials and many retrospective studies have been published, many uncertainties still mold the discussions on the best treatment management for men after prostatectomy. This research topic successfully intended to foster discussions on current controversies in the use of postoperative radiotherapy and to present novel perspectives for treatment optimization.

The use of radical prostatectomy in patients with high risk of recurrence has significantly increased during the past 10 years. Thus, adjuvant radiation as a part of multimodality treatment or salvage radiation at the evidence of prostate-specific antigen (PSA) progression represents mainstay curative-intent options for a great number of prostate cancer patients. Although, few randomized trials and many retrospective studies have been published, many uncertainties still mold the discussions on the best treatment management for men after prostatectomy. This research topic successfully intended to foster discussions on current controversies in the use of postoperative radiotherapy and to present novel perspectives for treatment optimization.

This interdisciplinary approach is reflected in the broad scope of this volume, which aims to provide an overview of current treatment strategies for bladder and prostate cancer. The first part of the book discusses the optimization of radiation techniques like 3D planning or IMRT and focuses on definitive radiotherapy with or without adjuvant or neoadjuvant hormonal manipulation. The quality of life after therapy is another important issue. Further chapters deal with radical cystectomy and organ preservation by radio-chemotherapy as well as the treatment of T1G3 cancer. In the last part, the emphasis lies on brachytherapy, which has become increasingly important for the treatment of prostate cancer. This book will be of great value to urologists and radiation oncologists as well as to all others involved in the care of patients with urologic cancer.

This reference reflects the evolution and advancement of best practices for the treatment of localized prostate cancer and the management of patients with early PSA progression in those failing local therapy. This guide contains chapters by authorities in specific areas of treatment including urologic, radiation, and medical oncology. Each expertly authored chapter details the best choice of candidates, possible complications that one may encounter during treatment, and a clear layout of the clinical outcomes with survival and period follow-ups.

Today, the arsenal of “high-precision” or “targeted” radiotherapy includes a variety of techniques and approaches that, like the pieces of a puzzle, need to be put together to provide the prostate cancer patient with high-level optimized radiation treatment. This book examines in detail the role of these innovative radiation techniques in the management of prostate cancer. In addition, a variety of current controversies regarding treatment are carefully explored, including whether prophylactic treatment of the pelvic lymphatics is essential, the magnitude of the effect of dose escalation, whether a benefit accrues from hypofractionation, and what evidence exists for the superiority of protons or heavy ions. Radiotherapy in Prostate Cancer: Innovative Techniques and Current Controversies is intended for both radiation oncologists and urologists with an interest in the up-to-date capabilities of modern radiation oncology for the treatment of prostate cancer.